Comparison of Once-Biweekly Administration of Epoetin-α with Darbepoetin-α in Chronic Kidney Disease Patients Not Receiving Dialysis

Korean Journal of Nephrology 2010;29(5):562-569.

So-Young Kim, M.D., Hae-Jin Choi, M.D., Hye-Jin Choi, M.D., Cho-ee Lee, M.D., Seon-Ung Yun, M.D., Jung-Hwan Park, M.D., Jong-Ho Lee, M.D., Jong-Oh Song, M.D. and Young-Il Jo, M.D.

Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea

원저 : 투석전 만성신부전 환자에서 Epoetin-α와 Darbepoetin-α의 2주 1회 요법의 조혈효과 비교

김소영, 최혜진, 최혜진, 이초이, 윤선웅, 박정환, 이종호, 송종오, 조영일

건국대학교 의학전문대학원 내과학교실 신장내과

Abstract

Purpose: It is very important to correct renal anemia by erythropoiesis stimulating agents (ESA) because anemia is associated with poor outcomes in chronic kidney disease (CKD) patients. We investigated whether once-biweekly (Q2W) treatment with epoetin-α (EPO-α) is as effective as Q2W darbepoetin-α (DA-α) in CKD patients who are not on dialysis. Methods: Fifteen CKD patients not receiving dialysis with renal anemia (M:F 6:9, age 60.1±7.2 years, eGFR-MDRD 15.7±6.4 mL/min/1.73m2, DM 46.7%) were enrolled. All patients received Q2W subcutaneous DA-α (40 ㎍) for 10 weeks. After 6 weeks of wash-out period, patients were switched to Q2W subcutaneous EPO-α (10,000 IU) for 10 weeks. Results: There were no significant differences in baseline parameters, such as hemoglobin (Hb), serum ferritin, and transferrin saturation, between before DA-α therapy and before EPO-α therapy. Hb levels significantly increased after completion of ESA therapy (DA-α, 9.8±0.4 vs. 10.4±0.6 g/dL, p=0.001; EPO-α, 9.6±0.7 vs. 10.2±0.4 g/dL, p=0.003). After completion of ESA therapy, Hb levels did not reveal significant differences between two groups (p=0.123). Erythropoietin resistance index (8.2±1.6 vs. 8.4±1.5 IU/kg weight/g hemoglobin/week, p=0.136) and % increase of Hb (106.7±5.5 vs. 106.8±6.4%, p=0.776) were not significantly different between DA-α therapy and EPO-α therapy. There were no significant adverse effects observed during study periods. Conclusion: These findings indicate that Q2W high dose (10,000 IU) of EPO-α therapy in CKD patients who are not on dialysis may be effective in maintaining Hb levels as Q2W DA-α therapy.

Key Words: Chronic kidney failure, Anemia, Erythropoietin